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Pregnant? A doula can help -- During labor, this helper is a woman's best friend

Doula Janelle Brandon holds one of the babies she was present for during an all-natural birth at Essentia Health in July of 2011. She had doulas for both of her children's births, and she's been present for 13 births as a doula herself.

About six years ago, Erin Foley had just had her second child and she read in a parenting magazine about birth doulas and thought it was an interesting idea.

"A doula (pronounced doo-lah) is basically professional labor support," Foley said. "We don't do anything medical. We're there to support the woman and her partner before, during and after childbirth."

She was intrigued, so she researched it more and found she had an even deeper interest.

"I really felt that that was something I wanted to do."

So she found DONA International online, found doulas in Minnesota and arranged for a trainer from the Twin Cities to come to Fargo to give the three-day training class.

It took her about a year to get certified after that.

'The most positive experience possible'

"It allows the mother to have the most positive experience possible with relaxation techniques, movements, to get pressure off different parts of the body and different exercises to relieve pain during contractions and during labor," said Nikki Bradbury.

Bradbury, of Vergas, is working on her certification to become a doula now, but it's a passion she experienced years ago.

When she was 19 years old, she served as a coach for a friend going through labor.

"I just thought it was the most incredible experience."

Down the road, Bradbury had her first child, who ended up being delivered via c-section.

"Then I read about things later and learned the more I think about it, there are other things that could have been done had I had a doula with me," she said.

It inspired her enough that in 2010, she started the process of becoming a doula. She attended the three-day training seminar in the Twin Cities and has since attended one birth. She has to attend two more before she can be certified.

Another mom in Detroit Lakes that is in the middle of getting her certification is Megan Hagel.

Foley, of rural Frazee, actually doulaed for her during the birth of her first child. Foley has gone on to be a doula for about 13 births.

"I was inspired by my doula, which Erin (Foley) doulaed for me. I decided to get more into it," Hagel said.

Wouldn't you like to be a doula, too?

So she started the process of getting certified as a doula herself. She's attended one birth, and then took time off to have her second child, which she also had a doula for.

For her first child, Hagel said she knew she wanted a natural birth so she decided to try a doula because of the extra help they could provide.

"I think one of the biggest things was to help me stay calm before and during the birth time," she said.

Her husband, she said, was also in favor of having a doula present just for support purposes.

"It was kind of like a calming presence in the room," she said.

The doula helps to relieve pressure during the birth -- like doing a hip squeeze -- and with positive re-enforcement, both verbally and emotionally. All of the women agree, a doula is there for the emotional aspect as much or more as the physical side of the birth.

"There's someone there that has the knowledge and the experience to kind of take away some of that stress of the moment -- someone to just be there for reassurance," Foley said. "They always say, the doula mothers the mother.

"It's kind of like having a guardian angel there for you. It doesn't mean everything is always going to go exactly like you had planned, but they're the one person there just for the mom the whole time."

Foley has taken time off as a doula to have her third child and is now pregnant with her fourth. She's already hired her doula, Janelle Brandon.

Brandon, a Frazee native, lives in the Fargo-Moorhead area and has doulaed for 13 births. She's also had doulas for the births of her two children.

When she and her husband were pregnant with their first child, they lived in the Twin Cities at the time and took the 12-week Bradley Method child birth education class. There, she learned about doulas and the benefits having one present.

She decided to look into having a doula at the birth of her son and found out that a friend was going through the certification process and needed to attend some births.

Doula helped her stay with the birth plan

After going into labor and being sent home because she wasn't far enough along in the process, Brandon said it was her doula --- and her husband -- that actually saved her and made her stick to her birthing plan they had agreed on earlier: a natural birth.

"We went back in and there wasn't much change. I was devastated," she said after being in labor for more than 24 hours. "I was like, 'ugh, done, I'm throwing in the towel, give me a c-section.' My husband stepped in at that point and said, 'You know, I don't think they just hand those out.'

"And my doula was behind him, nodding."

She said in the moment, she would have completely changed her birth plan had it not been for her doula's support.

"I would have asked for medication, I would have not stuck to my plan," she said.

Always on call

Once a woman chooses her doula, they meet a couple times before the baby is born to get a birth plan down. Foley said they talk about what kind of birth they want and envision the type of birth they want so the mother knows all her choices and the pros and cons of them.

During labor, the doula helps with physical support, different positions and massage, anything that is a natural pain relief technique. They, of course, are also there for emotional support, informational support and being the in-between person for the woman and the medical staff.

After the baby is born, doulas continue to help the mother if needed, especially with issues like breastfeeding for example.

"We're on call 24/7," Foley said.

Breastfeeding worries

Besides just having someone present for the birth of her child, Hagel said her doula was a big help with postpartum care as well.

"I wouldn't have been able to breastfeed (my daughter) if it wasn't for my doula," she said of Foley. "My daughter was tongue tied and she was having trouble breastfeeding. I would have given up, but luckily I was able to call Erin and she was able to sit down with me and she referred me to the lactation consultants.

"If it wasn't for her, I wouldn't have continued breastfeeding. Checking in with me (after the baby was born) meant the world to me," she added.

Almost all of the families she's worked with, Foley said she's become a close part of the family. She still gets Christmas cards from some of them, in fact, and she keeps in contact with several of the families. Most she didn't know before she doulaed for them.

Brandon said she hasn't known many of her families she has doulaed for either. But the new bond carries on.

"That bond is formed with everybody, and sometimes that includes grandma and grandpa and siblings. I've been invited to birthday parties of kids (she's doulaed for). Older siblings call me Janelle the Doula or Doula Janelle," she said with a laugh.

"It's a lifelong bond, and I feel that way about my doulas, too."

It's those relationships, she said, that shows the positive effect of having a doula present for the birth of a child.

"It's very humbling to walk that journey with these families," Brandon said.

"It's just such a beautiful thing to be a part of, but you do feel a little overwhelmed that you get to share that experience with them," Bradbury said.

Since she's still new at doulaing, Bradbury knew the one family that she's worked with so far.

"It was incredible," she said. "For the most part, she had such an easy (delivery). She slept a lot; she had an epidural early and was pretty relaxed. She utilized me when she wanted me -- didn't need a lot of hands on, she was pretty comfortable. Delivery went very, very quickly once we got to that point."

When working on certification, doulas in training must have mothers, doctors and nurses at the birth evaluate them, and results are sent in to the organization that certifies them.

Doctors, nurses & doulas

So far, Brandon said she's had a good relationship with medical personnel in the area. "It's kind of a mixed bag," she said. "Some places will have me sign a (form) saying that I won't do anything medical, that I won't infringe on any medical procedures they're trained to do. I think they do that because some doulas have behaved badly outside our scope of ethics (in the past)."

She said it's actually her favorite situation where the nurse and the doula work together. She added that unless the nurse has had a bad experience with a doula, most are open minded and accepting of doulas being present.

"The role of the doula is not to step on any toes. We are employed by the couple, not the hospital or any other entity. We are there so they get what they are hoping to achieve," she said.

With Foley taking a break from doulaing, there are no listed doulas in the Detroit Lakes area. Bradbury would like to finish up her certification requirements soon to have another doula in the area for mothers.

"It's something still new to our area. There are so many benefits," Foley said.

Doulas for all?

While it costs to have a doula present, once they are certified, Bradbury said the motto of the international organization is that all mothers who want a doula should have one.

"They encourage doulas that if there's someone who can't afford a doula to even offer to barter something or just reduce costs. Just so every mother that wants one can have one."

Prices can range from roughly $300 to $500 to have a doula present, but Bradbury said some insurance companies are starting to cover doula fees.

"It's a really great thing. I wish I would have done it with both of my boys. If I were to have any more, I would definitely have someone there," she said.

It's good to at least look into having a doula, Hagel said. It doesn't matter the birth plan the mother wants -- natural, with medication or a c-section -- a doula can help and make it a positive experience.

"They can be your support system. Their job is to support you for whatever kind of birth you want," she said.

Doulas are not the same as certified midwives, who provide medical care and advice to women before, during and after pregnancy. But a midwife and a doula can make a great team, according to the MyMidwife.org website.

Doula info classes

Brandon is a part of the Doulas of the Red River Valley, and the group is hosting a free information classes on doulas on June 14, July 12 and Aug. 9 at 7 p.m. in Nichole's Fine Pastry in Fargo.